Ligament damage during total knee replacement uncommon

November 1st — admin

My father had a total knee replacement that had some problems. During the operation one of his ligaments was damaged that was fine before the operation. Does this happen very often? Is it an indication that the surgeon wasn’t being careful?

Studies of hundreds of knee replacements show this can and does happen … even in patients with no risk factors or deformities. Ligament damage isn’t rare but it’s uncommon. It can happen to anyone but it does tend to occur in patients who are very overweight.

The surgeon usually repairs the surgically torn ligament. The surgeon may use an implant that is designed for use with a torn or absent ligament. Rotating-hinge knees are favored when the patient has severe joint instability. The doctor’s task is to balance the ligaments, stabilize the joint, and restore motion.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Posted in Knees. Tags: , , , , . No Comments »

Does joint injury always lead to arthritis?

October 14th — admin

I was in a car accident and crashed my left knee against the dashboard hard enough to break it. I’m only 23-years old and I know this might get arthritic later in life. What are options now to help prevent this from happening?

Good question. We don’t have studies to show the long-term results of each possible treatment option. Some may say don’t worry about it — what will be, will be. Others say don’t borrow trouble before it happens. In other words, not everyone develops arthritis in a joint after a traumatic injury. The event increases your risk but doesn’t guarantee it.

You didn’t mention what treatment you’ve had for this problem now. Sometimes even young people damage the patella enough that fracture healing isn’t possible. In those cases, the kneecap may be removed, a procedure called a patellectomy. Older folks might opt for a total knee replacement, especially if they already have arthritis in the knee. Middle-aged patients may be given the choice of just a kneecap replacement.

The biggest factor in long-term results may have to do with your knee alignment. Does the patella track up and down well during knee motion? Is it balanced and in the center? Does it tend to track more to one side or the other?

The knee joint axis is also important. Are you slightly knock-kneed or bow-legged? These positions can affect how well the knee holds up over the years.

Ask your doctor for his or her recommendations. It could be there’s nothing to be done just now. Or there may be an exercise program that could correct any weaknesses or misalignments.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Posted in Knees. Tags: , , , , , , , . No Comments »

Do you really need your kneecap?

October 7th — admin

Two years ago I had a total knee replacement. I was able to keep my own kneecap at the time. Last month I fell and broke my kneecap. It’s painful, and I want the doctor to take the kneecap out. Do I really need it anyway?

The kneecap (patella) has a very important job to do. It helps the knee joint move and work normally. The quadriceps muscle, the large muscle on the front of the thigh, comes down, crosses the patella and attaches to the lower leg bone. The patella acts as a pulley system to help you use the quadriceps muscle to straighten your knee. This is called the extensor mechanism.

Taking the patella out changes how the extensor mechanism works. Change in the forces around the knee from extensor lag can cause an unstable joint. There’s also a loss of protection of the bones in the knee joint.

Lastly, the appearance of your leg will change. This may not matter to you when you are in so much pain. Once the patella is gone you can’t get it back so it’s a fairly important decision.

Some doctors prefer patients try a conservative approach. This means pain management while the bone heals. Taking the patella out is more of a final treatment option.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Posted in Knees. Tags: , , , . No Comments »

What to expect from surgery to repair shattered kneecap

October 5th — admin

My mother fell and broke her kneecap into many little pieces. She’s having surgery to take them out. It’s complicated because she has a knee joint replacement in the same leg. I’ll be taking care of her. What can I expect?

Patellar fracture and patellectomy (removal of the kneecap) are fairly rare events. Since there aren’t very many cases reported, information about results is limited.

Doctors from the Mayo Clinic recently reported on eight cases of patellectomy after total knee replacement. Their patients were in a leg cast for six to eight weeks. After the cast was taken off, the patients started putting weight on the leg and began range of motion exercises.

Half the patients reported pain relief from this operation. Three people still had mild pain. One person had severe pain. Although the patellectomy gave them pain relief, motion and function were very poor even months to years later.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Posted in Knees. Tags: , , , . No Comments »

Will knee replacement interfere with this traveler’s plans?

October 3rd — admin

I have a trip to Italy planned in two months. I also need a knee replacement before I go. The surgeon offered me the new minimally invasive “faster” surgery. Should I do it?

It all depends on how important a quick recovery is to you…and how much it’s worth in terms of risk. There’s a chance that the implant won’t last as long as the standard joint replacement. This risk of early failure is usually accompanied by persistent pain.

On the other hand, most patients who have the mini-approach are back to their normal activities after only one to four weeks’ time. This would certainly fit in with your travel plans.

Studies done so far show no reason to think you shouldn’t go ahead with this plan. So long as you know the potential problems, you’ll know the worst that could happen. Bon voyage!

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Posted in Knees. Tags: , , , . No Comments »

Scar placement for minimally invasive knee surgery

September 29th — admin

Ten years ago I had a total knee replacement. The staples got infected and I have a huge, ugly scar on my leg. I hear they can do it now with a much smaller cut. Where is the scar for the new method of knee replacement?

Surgeons are trying different ways to use the mini-incision for knee joint replacement. Reports are favorable for the mid-vastus approach. This is similar to the standard incision in the middle of the knee but smaller and slightly off-center.

The quadriceps muscle along the front of the thigh is made up of four major muscles. They work together to straighten the knee. The inside muscle group of the quadriceps is called the vastus medialis.

The surgeon splits the vastus medialis muscle in the direction of its fibers. The incision starts just above the patella (kneecap) and goes down to just below the patella.

A slightly different incision may be used for obese or very muscular patients. The surgeon still starts above the patella but curves the line around the edge of the kneecap rather than cutting straight down. The scar looks more like a question mark.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Posted in Knees. Tags: , , . No Comments »

How to find best joint replacement surgeon

September 23rd — admin

How can I find a surgeon who is certified to do the new minimally-invasive knee joint replacements?

Orthopedic surgeons aren’t certified in any of the individual surgical techniques that they do. When new methods come out, each surgeon must get the training and practice needed before operating on patients.

Right now researchers suggest the new minimally-invasive (MI) method of joint replacement should only be done by some surgeons. They should have a high-volume arthroplasty practice. This means they do a lot of joint replacements.

The best results reported have come from high-volume total joint centers. Not all patients are selected for this procedure. Surgeons who choose patients carefully tend to have better results. Some might say it’s more important that the patients are “certified” than the surgeons.

Your best bet is to find a center that focuses just on joint replacement. Ask how many minimally-invasive knee replacements the surgeon has done before making your final choice.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Posted in Knees. Tags: , , . No Comments »

Which knee implant is better – plastic or metal?

September 21st — admin

I’m used to walking three to four miles a day even with my painful, arthritic knees. If I have a new joint put in should I go with the plastic or metal implant? Which one holds up best for walkers like me?

Good question…and one that is highly debated in the literature. After decades of using the metal-backed implants surgeons are trying the new all-poly (molded plastic) implants.

They say the metal backed implants can get worn unevenly causing the bone to deteriorate. The implant can loosen, too. On the other hand there’s concern that the polypropylene type won’t hold up under daily use by active adults.

Researchers at the Lenox Hill Hospital in New York City report results of the all-poly implant for a group of active, younger (less than 60 years old) adults. A majority of the patients said that walking distance was unlimited. A smaller number reported walking limited to 10 blocks or less.

Many of these active adults were also involved in swimming, tennis, and golf.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Posted in Knees. Tags: , , , , . No Comments »

Will patient need cane or walker after total knee replacement surgery?

September 19th — admin

If I have a total knee replacement on an outpatient basis will I still need to use crutches or a walker? I live in a tiny apartment and it would be easy to walk around holding onto the furniture.

Many people are able to go home with either a cane or using nothing. We can’t say for sure about you, but here are some things to think about. Do you use a walker or crutches now before the operation? If yes, then you’re more likely to need one afterwards…at least for a little while.

How strong is your other leg? Can it support you without the off-loading assistance provided by a walker or crutches? Many people have arthritis in both knees. They have the worst knee replaced first but this puts a lot of extra load on the other knee until the leg operated on gets stronger.

You may find it easy to navigate your apartment but need to use an assist when outside or walking in the community. The long-term goal is to walk unassisted and pain free.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Posted in Knees. Tags: , , , . No Comments »

Can patient with hemophilia have joint replacement surgery?

September 15th — admin

I have hemophilia that’s under fairly good control. My left knee is a real problem. I could really use a joint replacement. What’s the status of this operation for people with hemophilia?

Orthopedic surgery for joint replacement is an option for some patients with hemophilia. New drug therapy with inhibitors has allowed surgery to be done safely. It may depend on the type of missing platelet factor. The overall health of the patient can make a difference, too.

Rehab is offered before and after the operation. A preoperative rehab program is called prehabilitation. Exercises can increase motion and strength. This helps the patient get back up after surgery with faster recovery of function. It can also help minimize the risk of bleeding.

There are still problems with joint replacements for patients with hemophilia. Bleeding and infection are the biggest problems. There may be no improvement in motion.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Posted in Knees. Tags: , , , , . No Comments »
« Older posts «
»